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Pazopanib in Treating Patients With Metastatic Soft Tissue Sarcoma That Has Relapsed or Not Responded to Treatment
This study is currently recruiting participants.
Verified by National Cancer Institute (NCI), November 2009
First Received: November 19, 2008   Last Updated: November 3, 2009   History of Changes
Sponsor: European Organization for Research and Treatment of Cancer
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00794521
  Purpose

RATIONALE: Pazopanib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. It is not yet known whether pazopanib is more effective than a placebo in treating patients with soft tissue sarcoma.

PURPOSE: This randomized phase III trial is studying pazopanib to see how well it works compared with a placebo in treating patients with metastatic soft tissue sarcoma that has relapsed or not responded to treatment.


Condition Intervention Phase
Endometrial Cancer
Kidney Cancer
Metastatic Cancer
Ovarian Cancer
Peripheral Nervous System Neoplasm
Sarcoma
Small Intestine Cancer
Drug: pazopanib hydrochloride
Other: placebo
Phase III

Study Type: Interventional
Study Design: Treatment, Randomized, Double-Blind, Placebo Control
Official Title: A Randomized Double Blind Phase III Trial of Pazopanib Versus Placebo in Patients With Soft Tissue Sarcoma Whose Disease Has Progressed During or Following Prior Therapy.

Resource links provided by NLM:


Further study details as provided by National Cancer Institute (NCI):

Primary Outcome Measures:
  • Overall progression-free survival as define by RECIST criteria [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Overall survival [ Designated as safety issue: No ]
  • Adverse events as assessed by NCI CTCAE v 3.0 [ Designated as safety issue: Yes ]

Estimated Enrollment: 360
Study Start Date: October 2008
Arms Assigned Interventions
Arm I: Experimental
Patients receive oral pazopanib hydrochloride once daily for 28 days. Courses repeat every 28 days until disease progression or unacceptable toxicity.
Drug: pazopanib hydrochloride
Given orally
Arm II: Placebo Comparator
Patients receive oral placebo once daily for 28 days. Courses repeat every 28 days until disease progression or unacceptable toxicity.
Other: placebo
Given orally

Detailed Description:

OBJECTIVES:

Primary

  • Investigate whether treatment with pazopanib hydrochloride improves the outcome of patients with metastatic soft tissue sarcoma, when compared with placebo.

OUTLINE: This is a multicenter study. Patients are stratified according to the number of prior chemotherapy regimens for advanced disease (1 vs 2 or more), and WHO performance status (0 vs 1). Patients are randomized to 1 of 2 treatment arms.

  • Arm I: Patients receive oral pazopanib hydrochloride once daily for 28 days.
  • Arm II: Patients receive oral placebo once daily for 28 days. In both arms, courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.

After completion of study therapy, patients are followed every 8 weeks until disease progression and then every 3 months thereafter.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

DISEASE CHARACTERISTICS:

  • Histologically or cytologically confirmed high- or intermediate-grade* malignant soft tissue sarcoma, including any of the following subtypes:

    • Fibroblastic tumor (e.g., adult fibrosarcoma, myxofibrosarcoma, sclerosing epithelioid fibrosarcoma, and malignant solitary fibrous tumors)
    • Fibrohistiocytic tumor (e.g., pleomorphic malignant fibrous histiocytoma [MFH], giant cell MFH, and inflammatory MFH)
    • Leiomyosarcoma
    • Malignant glomus tumors
    • Skeletal muscle tumors (e.g., pleomorphic and alveolar rhabdomyosarcoma)
    • Vascular tumor (e.g., epithelioid hemangioendothelioma, and angiosarcoma)
    • Uncertain differentiation (e.g., synovial, epithelioid, alveolar soft part, clear cell, desmoplastic small round cell, extra-renal rhabdoid, malignant mesenchymoma, perivascular epithelioid cell tumor [PEComa], intimal sarcoma)
    • Malignant peripheral nerve sheath tumors
    • Undifferentiated soft tissue sarcomas not otherwise specified
    • Other types of sarcoma, if approved by the medical monitors NOTE: *Low-grade tumors are allowed provided there is disease progression.
  • Measurable disease

    • New lesions occurring in previously irradiated field are considered measurable
    • No previously irradiated lesions only disease
  • Disease progression by RECIST confirmed by radiological evaluation when compared to a disease assessment done within the past 6 months

    • Assessment may be done within the past 12 months in patients who had only received prior systemic neoadjuvant or adjuvant therapy
  • No more than 4 lines* of prior systemic therapy for advanced disease and meeting the following criteria:

    • No more than 2 of the lines should have been combination regimens
    • Disease has progressed on or after anthracycline-based regimen OR patients intolerant to the therapy
    • Disease has progressed on or after available standard chemotherapies unless medically contraindicated, therapy refused by patient, or patients intolerant to the therapy NOTE: *Neoadjuvant, adjuvant, and maintenance treatments are not counted for this criterion.
  • Metastatic disease

    • No locally advanced disease only
    • No known history of CNS metastases or leptomeningeal tumor spread
    • No known intraluminal metastatic lesions with risk of bleeding
    • No endobronchial lesions and/or lesions infiltrating major pulmonary vessels
  • The following tumor types are not allowed:

    • Adipocytic sarcomas (all types)
    • All rhabdomyosarcomas that are not alveolar or pleomorphic
    • Chondrosarcoma
    • Osteosarcoma
    • Ewing tumors and primitive neuroectodermal tumors
    • Gastrointestinal stromal tumors
    • Dermofibromatosis sarcoma protuberans
    • Inflammatory myofibroblastic sarcoma
    • Malignant mesothelioma
    • Mixed mesodermal tumors of the uterus
  • Formalin-fixed paraffin-embedded tumor blocks and/or representative hematoxylin/eosin slides (preferably both) must be available

PATIENT CHARACTERISTICS:

  • ANC ≥ 1,500/mm^3
  • Platelet count ≥ 100,000/mm^3
  • Hemoglobin ≥ 9 g/dL
  • Prothrombin time ≤ 1.2 times upper limit of normal (ULN)
  • Partial thromboplastin time OR INR ≤ 1.2 times ULN
  • Bilirubin ≤ 1.5 times ULN
  • AST and ALT ≤ 2.5 times ULN
  • Serum creatinine ≤ 1.5 mg/dL OR creatinine clearance ≥ 50 mL/min
  • Urine protein-creatinine ration (mg/dL) ≤ 1 OR 24-hour protein ≤ 150 mg
  • Not pregnant
  • Not nursing during study and for at least 14 days after completion of study treatment
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • No other prior malignancies within the past 3 years except for basal cell or squamous cell carcinoma of the skin or carcinoma in situ of the cervix or breast
  • Able to swallow and retain oral medication
  • No other malignancy within the past 3 years except basal cell or squamous cell carcinoma of the skin or carcinoma in situ of the cervix or breast
  • Toxicity from prior therapy has resolved to ≤ grade 1 (except alopecia) and is not progressing in severity
  • Cardiac function clinically normal by 12 lead ECG and no history of any cardiovascular conditions within the past 6 months including any of the following:

    • Myocardial infarction
    • Unstable angina
    • Symptomatic peripheral vascular disease
    • NYHA class III-IV congestive heart failure
  • No prolongation of QTc interval > 480 msecs by 12-lead ECG
  • LVEF normal by MUGA or ECHO
  • No poorly controlled hypertension (i.e., BP > 150/90 mm Hg)

    • Initiation or adjustment of antihypertensive medication is permitted prior to study entry and BP must be reassessed twice separated by ≥ 1 hour resulting in ≤ 150/90 mm Hg
  • Any of the following conditions are not allowed:

    • Prior cerebrovascular accident
    • Transient ischemic attack in the past 6 months
    • Deep venous thrombosis (DVT) or a pulmonary embolism in the past 6 months

      • Recent DVT treated with therapeutic anti-coagulating agents and remaining stable for at least 6 weeks allowed
  • No history of clinically significant gastrointestinal disorders including any of the following:

    • Malabsorption syndrome
    • Active peptic ulcer disease
    • Inflammatory bowel disease
    • Ulcerative colitis
    • Gastrointestinal conditions with increased risk of perforation
    • Abdominal fistula within the past 28 days
    • Gastrointestinal perforation within the past 28 days
    • Intra-abdominal abscess within the past 28 days
  • No evidence of active bleeding or bleeding diathesis
  • No hemoptysis within the past 6 weeks

    • Any patient with prior hemoptysis associated with metastatic disease must have endobronchial lesions ruled out by bronchoscopy
  • No major trauma within the past 28 days
  • No presence of any non-healing wound, fracture, or ulcer
  • No psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule
  • No known immediate or delayed hypersensitivity reaction or idiosyncrasy to drugs chemically related to pazopanib hydrochloride

PRIOR CONCURRENT THERAPY:

  • See Disease Characteristics
  • No cardiac angioplasty, stenting, or coronary artery bypass graft surgery within the past 6 months
  • More than 6 months since prior and no concurrent amiodarone
  • No major surgery within the past 28 days
  • More than 14 days since prior and no concurrent other anticancer therapy, including chemotherapy, immunotherapy, biologic therapy, radiotherapy, targeted agents, investigational therapy, or hormonal therapy
  • More than 14 days since prior and no concurrent substrates for the CYP450 enzymes, including any of the following:

    • Oral hypoglycemics (tolbutamide, chlorpropamide)
    • Ergot derivatives (dihydroergotamine, ergonovine, ergotamine, methylergonovine)
    • Neuroleptics (pimozide)
    • Antiarrhythmics (bepridil, flecainide, lidocaine, mexiletin, guanidine, propafenone)
    • Immune modulators (cyclosporine, tacrolimus, sirolimus)
    • Miscellaneous (theophylline, quetiapine, risperidone, tacrine, clozapine, atomoxetine)
  • No prior inhibitors of angiogenesis and/or VEGF- or VEGFR-targeting agents

    • mTOR inhibitors are not considered angiogenesis inhibitors
  • No major resection of the stomach or small bowel that could affect the absorption of study drug
  • No concurrent therapy with any specifically prohibited medication or requirement for using any of these medications during treatment with pazopanib hydrochloride
  • No concurrent hormone replacement therapy
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00794521

Locations
Netherlands
European Organization for Research and Treatment of Cancer Recruiting
Nijmegen, Netherlands, NL-6500 HB
Contact: Winette T. A. Van der Graaf, MD, PhD     31-24-361-0353        
Sponsors and Collaborators
European Organization for Research and Treatment of Cancer
Investigators
Principal Investigator: Winette T. A. Van der Graaf, MD, PhD Universitair Medisch Centrum St. Radboud - Nijmegen
  More Information

Additional Information:
No publications provided

Study ID Numbers: CDR0000624542, EORTC-62072, EU-20887, GSK-VEG110727, EUDRACT-2008-001307-33
Study First Received: November 19, 2008
Last Updated: November 3, 2009
ClinicalTrials.gov Identifier: NCT00794521     History of Changes
Health Authority: Unspecified

Keywords provided by National Cancer Institute (NCI):
adult alveolar soft-part sarcoma
adult angiosarcoma
adult desmoplastic small round cell tumor
adult epithelioid sarcoma
adult fibrosarcoma
adult leiomyosarcoma
adult malignant fibrous histiocytoma
adult malignant hemangiopericytoma
adult malignant mesenchymoma
adult neurofibrosarcoma
adult rhabdomyosarcoma
stage IV adult soft tissue sarcoma
recurrent adult soft tissue sarcoma
adult synovial sarcoma
clear cell sarcoma of the kidney
recurrent renal cell cancer
stage IV renal cell cancer
peripheral nervous system neoplasm
recurrent uterine sarcoma
stage IV uterine sarcoma
uterine carcinosarcoma
uterine leiomyosarcoma
ovarian sarcoma
endometrial stromal sarcoma
small intestine leiomyosarcoma
soft tissue metastases
ovarian carcinosarcoma
recurrent ovarian epithelial cancer
stage IV ovarian epithelial cancer

Additional relevant MeSH terms:
Gastrointestinal Diseases
Gonadal Disorders
Urogenital Neoplasms
Ovarian Diseases
Urologic Neoplasms
Ileal Diseases
Genital Diseases, Female
Duodenal Neoplasms
Neoplasms, Connective and Soft Tissue
Endometrial Neoplasms
Neoplastic Processes
Neoplasms by Site
Pathologic Processes
Neuromuscular Diseases
Ileal Neoplasms
Urologic Diseases
Jejunal Diseases
Kidney Neoplasms
Neoplasm Metastasis
Uterine Neoplasms
Kidney Diseases
Duodenal Diseases
Nervous System Neoplasms
Endocrine Gland Neoplasms
Jejunal Neoplasms
Digestive System Neoplasms
Ovarian Neoplasms
Neoplasms by Histologic Type
Nervous System Diseases
Genital Neoplasms, Female

ClinicalTrials.gov processed this record on February 08, 2010